血糖控制对2型糖尿病患者载脂蛋白A水平的影响

Effects of Glycaemic Control on Serum Apolipoprotein A in Type 2 Diabetic Patients

目的观察分析2型糖尿病患者载脂蛋白A(apoA)水平变化与血糖控制状态关系及其可能的影响机制。方法采用自动生化仪检测213名2型糖尿病患者血浆总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、极低密度脂蛋白(VLDL)、低密度脂蛋白(LDL)、载脂蛋白A(apoA)、载脂蛋白B(apoB),用离子交换高效液相色谱分析法测定糖化血红蛋白(HbA1c),比较其与血脂指标的相关性。结果两组HDL-C水平差异无统计学意义[(1.26±0.45)mmol/L vs(1.13±0.35)mmol/L,P>0.05];控制满意组apoA水平显著高于非满意组[(1.16±0.31)g/L vs(0.98±0.32)g/L,P<0.01],apoB/apoA显著低于非满意组(P<0.05)。TC、TG、LDL、VLDL水平两组差异无统计学意义(P>0.05)。直线相关分析显示apoA与HbA1c、FBG呈显著负相关(r=-0.30,P<0.01;r=-0.24,P<0.01);apoA与HDL、TC呈显著正相关(r=0.74,P<0.01;r=0.39,P<0.01)。结论2型糖尿病患者血糖控制状态显著影响apoA水平,这可能是HDL功能紊乱的重要原因。

Objective To investigate the effect of glycaemic control on serum apoA levels in patients with type 2 diabetes. Methods 213 type 2 diabetic patients were fasting sampled, and serum concentrations of triglyceride （TG）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C）, apolipoprotein A（apo A） and B（apo B） were measured by biochemical assays, while plasma HbAlc was determined by HPLC. Correlations between apoA and other lipid-related parameters were statistically analyzed by Pearson＇s correlation. Results Patients were divided to good-control group （HbAlc≤7.0%, n=68） and poor-control group （HbAlc〉7.0%, n=i35）according to the guideline of ADA 2007. Serum levels of TG, TC, LDL-C, HDL-C and apoB were comparable between 2 groups. Serum apoA was significantly higher in good-control patients than in poor-control individuals [ （1.16±0.31） g/L vs （0.98±0.32） g/L, P〈0.01 ], hence apoB/apoA ratio decreased in the former group. In all patients, apoA was negatively correlated with HbAlc （r=-0.30, P〈0.01 ）, and positively correlated with HDL （r=0.74, P〈0.01）. Conclusion State of glycaemic control exerts powerful effects on serum apoA in type 2 diabetic patients, which may play important roles in dysfunction of HDL molecules.